Contraceptive Health Care and "Religious Freedom" Arguments ... Or Facts Trump Theology

The bulk of this article uses research compiled for an article published by the Guttmacher Institute ("The Case for Insurance Coverage of Contraceptive Services And Supplies Without Cost-Sharing").

The 2010 health care reform law ("Affordable Care Act" or ACA) requires private health insurance plans to cover certain preventive health care services without any out-of-pocket to the consumer (e.g. no co-pays, no deductibles).

In November 2010, the Institute of Medicine (IOM) convened an advisory panel to develop guidelines for women's preventive care (a requirement added to the law by Senator Mikulski of Maryland). The legislative intent of this law was to include contraceptive counseling, contraceptive services and supplies, and annual well-woman gynecological exams.

The evidence support contraceptive health care services as an essential component of both individual preventive care and public health care. The Guttmacher Institute's report provides an excellent summary of the importance of contraceptive coverage:

Contraceptive use helps women avoid unintended pregnancy and improve birthspacing, which in turn have substantial positive consequences for infants, women, families and society. Moreover, although cost can be a daunting barrier to effective contraceptive use on the part of individual women, the evidence strongly suggests that insurance coverage of contraceptive services and supplies without cost-sharing is a low-cost or even cost-saving means of helping women overcome this obstacle.

Here's a summary of the benefits provided by making contraceptive use easier for children, women, families, and society from the Guttmacher report:

• In the United States, increased contraceptive use—particularly among unmarried women and among teenagers—has paralleled substantial declines in unintended pregnancy and abortion. Notably, increased contraceptive use has been found to be responsible for 77% of the sharp decline in pregnancy among 15–17-year-olds between 1995 and 2002, and for all the decline among 18–19-year-olds over that period.


• According to U.S. and international studies, a causal link exists between the interpregnancy interval (the time between a birth and a subsequent pregnancy) and three major birth outcomes measures: low birth weight, preterm birth and small size for gestational age.


• In addition, according to a 2008 literature review, numerous U.S. and European studies have found an association between pregnancy intention and delayed initiation of prenatal care.


• Furthermore, compared with children born from intended pregnancies, those born from unintended pregnancies are less likely to be breastfed at all or for a long duration. Breastfeeding, in turn, has been linked with numerous positive outcomes throughout a child’s life.


• Moreover, although evidence is limited, several studies from the United States, Europe and Japan suggest an association between unintended pregnancy and subsequent child abuse. There is also some evidence of an association between unintended pregnancy and maternal depression and anxiety.


• Both married and cohabiting couples are more likely to separate after an unintended first birth than after an intended first birth.


• Moreover, compared with those who have had a planned birth, women and men who have had an unplanned birth report less happiness and more conflict in their relationship, and women report having more symptoms of depression.


• Several studies have examined the role that contraceptive use—particularly the use of oral contraceptives—has played in improvements in social and economic conditions for women. The advent of the pill allowed women greater freedom in career decisions, by allowing them to invest in higher education and a career with far less risk of an unplanned pregnancy.


• Several studies have found that legal access to the pill led to increased pill use, fewer first births to high school– and college-aged women, increased age at first marriage, increased participation by women in the workforce and more children born to mothers who were married, college-educated and had pursued a professional career.


• A 2010 analysis of the literature found that hormonal contraceptives can help address several menstrual disorders, including dysmenorrhea (severe menstrual pain) and menorrhagia (excessive menstrual bleeding). Hormonal contraceptives can also prevent menstrual migraines, treat pelvic pain due to endometriosis and treat bleeding due to uterine fibroids. Perhaps most notably, oral contraceptives have been shown to have long-term benefits in reducing a woman’s risk of developing endometrial and ovarian cancer, and short-term benefits in protecting against colorectal cancer.


• Moreover, a 2000 study by the National Business Group on Health, a membership group for large employers to address their health policy concerns, estimated that it costs employers 15–17% more to not provide contraceptive coverage in their health plans than to provide such coverage, after accounting for both the direct medical costs of pregnancy and indirect costs such as employee absence and reduced productivity.

So ... we have facts supporting the case for contraceptive preventive care improves the situations of women, children, families, and society.

All I can find on the US Conference of Catholic Bishops web site about this law is that they object to it and that they are wrapping their objections in "religious privilege" that they want to extend to their non-profit organizations that provide secular services (e.g. education, health care, etc). If there are any factual objections to providing contraceptive care, it would be in their interests to voice them.

All that tells me is that these clergy leaders value their theology more than they value the well-being of children, women, families, and society (I'm assuming that these leaders are educated men who have ready access to the same facts that I have presented here).

They are free to promote this unhealthy idolatry of theology in their churches.

But this freedom doesn't extend to the secular world where their non-profit organizations employ non-Catholics who are engaged in non-religious work (health care, education, social services, etc). Theology doesn't exempt religiously-affiliated non-profits from religiously neutral laws that promote the common good.

We are lucky that these attitudes against contraceptives are not shared by a majority of Catholic laity.

Most Catholic laypersons support contraceptive use and a majority does support providing contraceptives as part of the ACA:

A new poll is out from Public Policy Polling, conducted on behalf of Planned Parenthood, on voter attitudes toward the new Obama administration requirement that employers who provide health insurance must also cover, co-pay-free, prescription birth control.

The PPP poll finds that "a 53 percent majority of Catholic voters, who were oversampled as part of this poll, favor the benefit, including fully 62 percent of Catholics who identify themselves as independents."

The poll also found 57% of all voters (and a 53% majority of Catholics) "think that women employed by Catholic hospitals and universities should have the same rights to contraceptive coverage as other women."